14326 Bladder Cancer

Overview

Bladder cancer is a type of cancer that starts in the bladder, the hollow organ in your lower belly that stores urine. It happens when cells in the bladder lining grow out of control. Most cases are found early, when treatment works well.

Bladder cancer is the 9th most common cancer worldwide. It is the 6th most common cancer in men in the UK. Around 10,000 people are diagnosed with bladder cancer each year in the UK.

Bladder cancer is more common in older adults, with most cases in people over 60. Men are about 3 to 4 times more likely to get it than women. It is very rare in children.

Symptoms

Common symptoms

• Blood in urine (wee) – the most common symptom, which may look pink, red, or dark brown
• Pain or burning when urinating
• Needing to urinate more often or more urgently than usual
• Feeling like you cannot fully empty your bladder
• Lower back or pelvic pain

Causes

Main causes

• Smoking – harmful chemicals in smoke build up in urine and damage the bladder lining
• Exposure to certain industrial chemicals, such as those used in dye manufacturing, rubber, leather, and some textiles
• Previous radiation therapy to the pelvic area
• Chronic, long-term bladder infections or bladder stones
• Some chemotherapy medicines (like cyclophosphamide) used for other conditions

Risk factors

• Being over 60 years old
• Being male – bladder cancer is 3 to 4 times more common in men
• Smoking – includes cigarettes, cigars and pipes
• Working with certain chemicals without proper protection
• Having a family history of bladder cancer
• Certain medical conditions, such as long-term urinary catheters or previous bladder surgery

When to see a doctor

See a doctor urgently if:

• If you see blood in your urine – book an urgent appointment with your GP
• If you have severe pain or difficulty urinating – seek same-day medical advice
• If your urine is dark, cloudy, or has clots – contact your GP or local health service immediately

Book a routine appointment if:

• If you notice any changes in how often you urinate, or a burning feeling that lasts longer than a few days
• If you have pelvic or lower back pain that does not go away
• If you feel tired, have lost weight without trying, or have a poor appetite

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and lifestyle. They will send a urine sample to test for blood, infection and abnormal cells. If bladder cancer is suspected, a GP will usually refer you to a specialist (urologist) for further tests.

Tests that may be done

• Urine test – to look for blood, infection, or abnormal cells
• Cystoscopy – a thin tube with a camera is passed into the bladder to examine the lining
• Biopsy – during cystoscopy, a small piece of bladder tissue may be taken for testing
• CT scan or ultrasound – imaging scans to see if cancer has grown or spread

What to expect at your appointment

Cystoscopy can feel uncomfortable, but it usually takes 5 to 10 minutes and you can often go home the same day. Waiting for test results can be worrying – ask your healthcare team how long it will take and how you will be told.

Treatment

The type of treatment you receive depends on the type of bladder cancer, how far it has grown (the stage), the grade (how abnormal the cells look), your general health, and what you prefer. Your specialist team will explain the options and help you make a decision.

Self-care at home

• Stop smoking – it is the most important thing you can do to improve your health and the success of treatment
• Drink plenty of fluids to help flush your bladder, unless your doctor says otherwise
• Get enough rest and try to stay as active as you feel able
• Ask for practical and emotional support from family, friends, or your healthcare team

Medical treatments

Treatment may include surgery to remove the cancer, radiotherapy (using high-energy rays to kill cancer cells), chemotherapy (medicines to kill cancer cells), immunotherapy (medicines that help your immune system fight the cancer), and for advanced disease, targeted therapy. The exact medicines and combinations depend on your individual situation and are tailored to you.

When is surgery considered?

For early-stage bladder cancer, the standard surgery is called transurethral resection – the surgeon removes the tumour through the urinary opening using a special instrument. For more advanced cancer, surgery to remove the whole bladder (cystectomy) may be recommended. After a cystectomy, your surgeon will discuss ways to collect urine, which may include urostomy bags or reconstructive options.

Living with this condition

Living with bladder cancer means regular check-ups and follow-up tests. You may need to adjust daily routines, especially after surgery. If you have a urostomy, you will learn how to care for it – most people adapt well with support from specialist nurses.

Lifestyle tips

• Keep up with healthy habits – avoid smoking, limit alcohol, and stay physically active as much as possible
• Protect yourself from chemical exposure at work – wear protective clothing and follow safety guidelines
• Try to keep a stable schedule for eating, resting, and taking care of yourself
• Stay connected with loved ones – sharing your feelings can reduce stress

Diet and exercise

A balanced diet full of fruits, vegetables and wholegrains can help you feel stronger. Aim for moderate exercise, like walking or swimming, as long as your doctor says it is safe. Drinking plenty of water (unless your doctor advises otherwise) is important for bladder health. Very small changes can make a real difference in how you feel.

Mental health and emotional wellbeing

A cancer diagnosis can bring up anxiety, fear and sadness. These feelings are normal. Treatments and side effects can also affect your mood and sense of self. Talking to a counsellor, joining a support group, or simply telling a close friend how you feel can help you cope. You are not alone.

Prevention

There is no guaranteed way to prevent bladder cancer, but you can reduce your risk. Not smoking is the biggest step. At work, always follow chemical safety guidelines. Drinking plenty of fluids may lower the concentration of harmful substances in your urine.

Vaccines

There are no vaccines to prevent bladder cancer. However, certain infections that increase risk of other cancers are preventable with vaccines – talk to your doctor if you have questions.

Screening programmes

No general screening program exists for bladder cancer. If you have a higher risk (such as previous bladder tumours or a family history), your specialist may recommend regular checks with urine tests or cystoscopy.

Complications

If left untreated

• The cancer may grow deeper into the bladder wall and spread to lymph nodes, bones, lung or liver
• It can cause ongoing bleeding and anaemia
• Tumours can block the flow of urine, damaging the kidneys
• If advanced, it may become harder to treat and can become life-threatening

Long-term outlook

The outlook for bladder cancer is generally good when it is caught early. Many people are cured after treatment. Even for more advanced bladder cancer, modern treatments can control the disease, relieve symptoms, and improve quality of life for many years. Your specialist team will talk honestly with you about your individual outlook, and they will support you and your family through every stage.

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